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This is the first time I will be providing clinical instruction at this facility. First, I would prepare myself using reflection. By reflecting on past and present situations I will be able to rethink problems and improve upon approaches or utilize different practices in the future. Reflecting makes the individual aware of past, present and future actions to better understand those actions so enhancement or change can occur (Edwards, 2017). Next, I would employ the suggestions of seasoned instructors who have experience with clinical planning taking into consideration constructive feedback when preparing the overview of the clinical rotation.
Employing the assistance of experienced nursing instructors can help novice instructors build an environment of creative learning through information sharing (Knowles, 2016).
I would research what students know in order to build upon knowledge and skills by reviewing didactic material from previous courses and the current theory course, NURS 311 Care of the Adult in Long Term Care and skills labs. This will assist with determining proper learning objectives.
Faculty needs to design and develop curriculum that builds on antecedent knowledge in order to achieve desired outcomes (Billings and Halstead, 2016). Finally, I would set up a shadowing experience with the coordinator at the facility to orient me to the unit and routine, introduce me to the interdisciplinary staff and update me on current healthcare trends, supplies and equipment utilized. I would also ask for policy and procedures of the facility. Instructors that are familiar with policies, procedures and following the routine and practices of a unit, establishes an open and positive working environment with staff members (Gaberson, Oermann and Shellenbarger, 2015).
First, I would target the following 9 interdisciplinary team members based on their role and responsibilities for patient care that coincide with learning objectives for the course:
I would discuss that there will be 8 sophomore level students in a pre-licensure baccalaureate program who will be at the clinical site one 8-hour day, 7am to 3pm, weekly for 12 weeks and this is the students’ first clinical experience with adult patients. Discussion will also include the following skill performances students will be doing related to the clinical experience:
I would inquire as to the unit routine and unit norms and ask what they expect of students. Taking the time to establish an effective working relationship with staff is important for establishing expectations (Gaberson, et al., 2015).
Question 3: With respect to the first clinical day at the facility, what information would you provide and what activities would you perform for orienting the students to the agency and the assigned unit? Be specific.
I want the students to feel comfortable and prepared. For this to happen, clear communication on both ends needs to be initially set up and continuously maintained during the course especially regarding behaviors, attitudes and safe practices. This will include a discussion about consequences if practices are not properly followed. Before the start of the clinical rotation, I would confirm that everyone read and understand school and facility policy and procedure and adherence is expected. I would also reinforce accountability of professional behavior and above all, patient safety and confidentiality practices. Clinical expectations should be reinforced the first day of the clinical rotation for questions or to clear up any misconceptions (Knowles, 2016).
I plan to establish and maintain a trusting relationship with the students by being a liaison, resource and role model. This will be accomplished by having an open and honest relationship with them. I will tell students they are new practitioners and therefore, not expected to know everything, but to take the initiative for every learning opportunity and to ask questions, seek guidance or clarification as appropriate. Providing support, clear communication, constructive feedback regarding performance and role modeling ethical behaviors develops trust (Knowles, 2016).
A handout will be given before clinical which will include:
The students will be given a tour of the facility including a general walkthrough of the unit and staff introductions. A scavenger hunt of the unit will be given the first day to orient them to the unit. They will be placed in 4 groups of two and given time to complete the scavenger hunt. A good way to orient students to a specific unit or hospital setting is with a scavenger hunt; it also is an entertaining activity known to lessen anxiety (Gaberson, 2015).
This rotation involves clinical assignments involving care for patients having multiple and complex medical diagnoses and who require skilled nursing care. Patient assignments will be given out the day before during a pre-briefing session utilizing the dual assignment method. The duel assignment method has the benefits of collaboration, communication and effective use of time management especially when the patient assignment is too complicated for one student (Billings and Halstead, 2016). During the pre-briefing session, an outline of specific goals and expectations of what each student will be practicing regarding the plan of care for the patient such as intravenous insertion, dressing changes, medication administration and ADLs will be discussed. This will enable each student to review the patient diagnosis, focus on specific procedures or tasks the patient will require and verbalize concerns for care of the patient. Students need to understand specific goals for the day and come properly prepared to perform procedures (Knowles, 2016). I will communicate student goals with the interdisciplinary team on procedures the students are allowed to perform and others that require observation so the team can clearly understand the roles of the student beforehand.
Clinical Teaching Strategies:
X One patient assignment will be given to 2 students. When patients are complex, this strategy promotes collaboration and communication and each student can focus on certain tasks or procedures. This strategy also improves upon time management (Billings and Halstead, 2016).
X Pre-clinical conferences provide the opportunity for critical conversations beforehand. During preclinical conference, students are able to share info about upcoming experiences, ask questions, express concerns, or seek clarification about plan of care (Billings and Halstead, 2016).
X Mid-clinical conferences provide additional opportunities for discussion. Continuous sharing of pertinent patient information helps students collectively evaluate efficacy from prior patient interventions (Billings and Halstead, 2016).
X Post-clinical conferences provide debriefing opportunities to discuss the clinical experiences and share information on how the individual identified issues, analyzed situations and felt; different viewpoints and clarification of content can be discussed (Billings and Halstead).
X Concept maps involve presenting information in a structured method aimed at developing meaningful learning; concept maps also help the student understand and recognize the connection of information (Akcay, 2017).
Students should be familiar with the policy and procedure of the school of nursing regarding the clinical expectation of patient confidentially under the Health Insurance Portability and Accountability Act (HIPAA). In this case, I would immediately discuss the issue with the student in a private setting. The discussion would include how the individual breached patient confidentiality and how the behavior poses a threat to the patient. Nursing programs have a responsibility to ensure their nursing students protect the safety and confidentiality of patients and are held to the same standard as licensed nurses (Knowles, 2016).
I would report this issue to the Clinical Coordinator and the Director of Nursing and document the event. I would tell the individual not to report to clinical and that notice of an opportunity to discuss the situation with the Clinical Coordinator of the program and Director of Nursing (DON) will be given. I would explain to her she has rights and will be treated in a fair and just manner. Students have rights of due process, fair treatment, confidentiality and privacy according to legal guidelines (Billings and Halstead, 2016).
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